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Pharmacy Medical Necessity Guidelines: AntiObesity Medications Effective: January 16, 2017, Prior Authorization Required Type of Review Care Management Not Covered Type of Review Clinical Review Pharmacy
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What is pharmacy medical necessity guidelines?
Pharmacy medical necessity guidelines are criteria established by insurance companies or government programs to determine the appropriateness of certain medications or treatments.
Who is required to file pharmacy medical necessity guidelines?
Healthcare providers or pharmacists are typically responsible for submitting pharmacy medical necessity guidelines for review.
How to fill out pharmacy medical necessity guidelines?
Pharmacy medical necessity guidelines should be filled out accurately and completely, following the specific instructions provided by the insurance company or program.
What is the purpose of pharmacy medical necessity guidelines?
The purpose of pharmacy medical necessity guidelines is to ensure that medications and treatments are used appropriately, based on medical necessity and evidence-based guidelines.
What information must be reported on pharmacy medical necessity guidelines?
Pharmacy medical necessity guidelines typically require information such as patient demographics, diagnosis, medication or treatment requested, and supporting documentation.
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